Dynamics of penicillin-susceptible clones in invasive pneumococcal disease.

In a 10-year period, 1987-1997, there was a >4-fold increase in the rate of pneumococcal bacteremia in Sweden. Invasive pneumococcal isolates (n=1136), which were obtained from 18 Swedish clinical microbiology laboratories from 1987 through 1997, and other national and international isolates were serotyped, and their clonal relationships were determined by molecular typing. The increase in invasive pneumococcal disease in Sweden during this period was associated particularly with an increase in isolates of serotypes 1 and 14. A 3-fold increase of type 14 was seen from 1987 through 1992, and a 10-fold increase of type 1 occurred from 1992 through 1997. One dominating penicillin-susceptible clone of type 14 was responsible for the increase of type 14 during the first 5 years. This clone also was found in Canada and the United States and was shown by multilocus sequence typing to correspond to a previously identified hyper-virulent clone. A novel penicillin-susceptible clone of type 1, which was not found among invasive isolates from 1987 or 1992, was responsible for the increase of serotype 1 during the last 5 years. These results illustrate the ability of virulent penicillin-susceptible pneumococcal clones to emerge and spread rapidly within a country.

[1]  A. Ortqvist,et al.  Changes in serotype distribution may hamper efficacy of pneumococcal conjugate vaccines in children. , 2001, Scandinavian journal of infectious diseases.

[2]  B. Spratt,et al.  Prevention of pneumococcal disease by vaccination: does serotype replacement matter? , 2000, The Lancet.

[3]  T. Marrie,et al.  Molecular epidemiology of Streptococcus pneumoniae causing invasive disease in 5 countries. , 2000, The Journal of infectious diseases.

[4]  A. Pawłowski,et al.  Preparation of pneumococcal capsular polysaccharide-protein conjugate vaccines utilizing new fragmentation and conjugation technologies. , 2000, Vaccine.

[5]  B. Spratt,et al.  A multilocus sequence typing scheme for Streptococcus pneumoniae: identification of clones associated with serious invasive disease. , 1998, Microbiology.

[6]  M. Kalin.  Pneumococcal serotypes and their clinical relevance , 1998, Thorax.

[7]  K. Ekdahl,et al.  Bacteraemic pneumococcal infections in Southern Sweden 1981-96: trends in incidence, mortality, age-distribution, serogroups and penicillin-resistance. , 1998, Scandinavian journal of infectious diseases.

[8]  H. Verbrugh,et al.  Penicillin-resistant Streptococcus pneumoniae in the Netherlands: results of a 1-year molecular epidemiologic survey. , 1997, The Journal of infectious diseases.

[9]  J. Giesecke,et al.  Increase in pneumococcal bacteraemia in Sweden , 1997, The Lancet.

[10]  M. Leinonen,et al.  Epidemiology of invasive Streptococcus pneumoniae infections in adults in Finland , 1997, Epidemiology and Infection.

[11]  S. Sylvan,et al.  Carriage of multiresistant Streptococcus pneumoniae among children attending day-care centres in the Stockholm area. , 1997, Scandinavian journal of infectious diseases.

[12]  J. Henrichsen,et al.  Incidence of invasive pneumococcal disease and distribution of capsular types of pneumococci in Denmark, 1989–94 , 1996, Epidemiology and Infection.

[13]  L. Nicolle,et al.  Pneumococcal bacteremia in two tertiary care hospitals in Winnipeg, Canada. Pneumococcal Bacteremia Study Group. , 1996, Chest.

[14]  J. Hedlund,et al.  Incidence, capsular types, and antibiotic susceptibility of invasive Streptococcus pneumoniae in Sweden. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  S. Gove,et al.  Potential interventions for the prevention of childhood pneumonia: geographic and temporal differences in serotype and serogroup distribution of sterile site pneumococcal isolates from children--implications for vaccine strategies. , 1995, The Pediatric infectious disease journal.

[16]  A. van Belkum,et al.  Comparative study of five different DNA fingerprint techniques for molecular typing of Streptococcus pneumoniae strains , 1995, Journal of clinical microbiology.

[17]  J. Verhaegen,et al.  Capsular types and antibiotic susceptibility of pneumococci isolated from patients in Belgium with serious infections, 1980-1993. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[18]  R. Breiman,et al.  Serotype distribution of Streptococcus pneumoniae infections among preschool children in the United States, 1978-1994: implications for development of a conjugate vaccine. , 1995, The Journal of infectious diseases.

[19]  F. Tenover,et al.  Emergence of drug-resistant pneumococcal infections in the United States. , 1994, JAMA.

[20]  A. Tomasz,et al.  Evidence for the introduction of a multiresistant clone of serotype 6B Streptococcus pneumoniae from Spain to Iceland in the late 1980s. , 1993, The Journal of infectious diseases.

[21]  M. Hjálmarsdóttir,et al.  Increasing penicillin resistance in pneumococci in Iceland , 1992, The Lancet.

[22]  R. van Furth,et al.  Mechanisms of host defense against infection with Streptococcus pneumoniae. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  M. Leinonen,et al.  Aetiology, outcome and prognostic factors in community-acquired pneumonia requiring hospitalization. , 1990, The European respiratory journal.

[24]  J. C. Parke,et al.  Considerations for formulating the second-generation pneumococcal capsular polysaccharide vaccine with emphasis on the cross-reactive types within groups. , 1983, The Journal of infectious diseases.

[25]  E. Hook,et al.  Failure of intensive care unit support to influence mortality from pneumococcal bacteremia. , 1983, JAMA.

[26]  R. Austrian.  Some observations on the pneumococcus and on the current status of pneumococcal disease and its prevention. , 1981, Reviews of infectious diseases.

[27]  J. Henrichsen,et al.  Chapter XI Laboratory Diagnosis, Serology and Epidemiology of Streptococcus pneumoniae , 1978 .

[28]  M. Finland,et al.  Changes in occurrence of capsular serotypes of Streptococcus pneumoniae at Boston City Hospital during selected years between 1935 and 1974 , 1977, Journal of clinical microbiology.

[29]  M. Mufson,et al.  Capsular types and outcome of bacteremic pneumococcal disease in the antibiotic era. , 1974, Archives of internal medicine.

[30]  E. Lund.  Distribution of Pneumococcus Types at Different Times in Different Areas , 1971 .

[31]  S. Halbert,et al.  THE USE OF PRECIPITIN ANALYSIS IN AGAR FOR THE STUDY OF HUMAN STREPTOCOCCAL INFECTIONS , 1958, The Journal of experimental medicine.

[32]  S. Halbert,et al.  THE USE OF PRECIPITIN ANALYSIS IN AGAR FOR THE STUDY OF HUMAN STREPTOCOCCAL INFECTIONS , 1955, The Journal of experimental medicine.